Wolff-Parkinson-White Syndrome (WPW)

Overview – In wolf-Parkinson-white syndrome, there is an additional electrical pathway, known as an accessory pathway (also called the bundle of Kent), which directly connects the atria (upper chambers of the heart) and ventricles (lower chambers of the heart). This disrupts the regular rhythm of the heart.

 

In the normal heart, the atria and the ventricles are electrically isolated.

 

When there is an absence of symptomatic arrhythmias, but electrocardiogram shows the preexcitation manifestation, the condition is called the WPW pattern.

 

WPW syndrome is applied when symptomatic arrhythmias involving the accessory pathway occurs along with the changes on the electrocardiogram.

 

Little is known about why there is an extra pathway. This extra pathway is present at birth. In a small percentage of people, the cause is an abnormal gene.

 

The other associated heart abnormalities with WPW are Ebstein anomaly and hypertrophic cardiomyopathy.

 

 

Symptoms

  • The majority of the people with WPW are asymptomatic. A small percentage of people who develop arrhythmia may develop one or more of the following symptoms –
  • Lightheadedness
  • Dizziness
  • Palpitations
  • Syncope
  • Chest pain
  • Sudden cardiac arrest

 

Complications of WPW

  • There may be an increased risk of serious heart-related events such as fast heartbeats leading to sudden death.

 

Diagnosis of WPW

  • The heart tests that are done to diagnose WPW are electrocardiogram, portable electrocardiogram that records the heart activity for 24 hours, electrophysiological testing using catheters.

 

Lifestyle management

  • Talk to your doctor about the vagal maneuvers to do when you experience a fast heartbeat. Vagus nerve when stimulated helps slow down the heart rate. Maneuvers that stimulate the vagus nerve are holding the breath and bearing down, coughing, immersing your face in ice-cold water, gagging.
  • Follow a healthy diet and exercise program recommended by your doctor.

 

Medical management

  • For people with symptoms and hemodynamically stable, the initial treatment is a vagal maneuver. If the vagal maneuver is ineffective, adenosine, verapamil, or beta-blockers is instituted. Intravenous procainamide may be used if these medications do not reduce the heart rate.
  • Urgent electrical cardioversion is done for people who are felt to be hemodynamically unstable with symptoms.
  • Radiofrequency catheter ablation – Ablation permanently corrects the heart-rhythm problems in most people. The extra electrical pathway is destroyed.

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